Bought this topper about a month ago while trying to put off buying a mattress set for a few more months. Our bed is a serta pillow top that has imprints of where our bodies lay so we needed to plump those spots up a bit. We bought this one. It was a great choice for us. It firmed up those spots without being hard on our bodies. It's like having a newer firmer bed again.. yet it is soft enough to pass for a plush mattress. I can feel the quilted areas if I really feel over the top of the fit sheet.. but I have to say that it doesn't irritate me at all. I can't stand to be laying on top of a wrinkled sheet ~ That's how sensitive I am to wrinkles. It's an overall very smooth surface. It doesn't add a lot of bulk to the mattress itself. The sheets still covered just fine. I have bamboo sheets which is another very comforting feature. (they stay cool) Speaking of cool, this mattress does not add heat at all to the bed. The top sheet stays cool. I would describe the "puff" as little pillows that raise your body above the actual mattress and I would very highly recommend this on a firmer bed. It would make it plush to pillow top worthy. I think that it's very much worth the money that it cost me and I have no idea how well it will hold up, but it's like new after a month. Washing it is tricky. It's bigger (I have a king) and it's bulky.. We hung it out to dry since some say that it could melt in the dryer. Our method has worked through 2 washing. I washed it more often just to see how it holds up... some people wash them only when absolutely necessary... just change the sheets often.